DESCRIPTION: (Applicant's Abstract) This is the competing continuation application of the San Francisco Treatment Research Center (TRC). In the last 3-1/2 years, TRC investigators have collaborated productively in science, training, and dissemination. The specific aims of the four currently funded components will be met, and expanded upon. The current application is unified around a theme of behavioral treatments of complex drug abusing patients in new settings. Four scientific components are proposed, supported by two cores. The primary project in each component is a controlled clinical trial of an innovative intervention in a "real-life" setting, with cross-component collaboration in descriptive, pilot, and integrative studies. Each component targets a group of drug abusers with a serious co-occurring disorder. The four components are: (1) a trial of a behavioral skills training intervention to promote reduction in drug use of drug dependent seriously mentally ill patients in clinical case management programs; (2) a trial evaluating the effects of a voucher-based contingency system on drug use and health maintenance behaviors of HIV-positive opioid users in methadone treatment; (3) a trial to evaluate intervention strategies provided in a hospital-based medical emergency department to link opioid users with acute medical problems to methadone treatment; and (4) a trial to evaluate a behavioral intervention for nicotine dependence for smokers with depressive disorders who are patients of a psychiatric outpatient clinic. The scientific and administrative core provides support for training, dissemination, measurement, health economics, and administration, as well as providing an integrating intellectual focus. The biostatistical core provides advanced statistical support, and uses data from the planned components to complete relevant research.